Provider Demographics
NPI:1326074121
Name:PAYNE, PAULA DONAHUE (RD)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:DONAHUE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751
Mailing Address - Street 2:6200 STATION DRIVE
Mailing Address - City:BEALETON
Mailing Address - State:VA
Mailing Address - Zip Code:22712-0751
Mailing Address - Country:US
Mailing Address - Phone:540-364-0153
Mailing Address - Fax:540-937-4273
Practice Address - Street 1:6200 STATION DR
Practice Address - Street 2:
Practice Address - City:BEALETON
Practice Address - State:VA
Practice Address - Zip Code:22712-9374
Practice Address - Country:US
Practice Address - Phone:540-364-0153
Practice Address - Fax:540-937-4273
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered